A semi-biased commentary on British and American politics, culture and current affairs

Death Panels

The headline seemed too implausible, too sensationalist to be true, but you can’t make stuff like this up – Sarah Palin called on people to “bomb Obamacare” as her political action committee released their latest anti health reform advertisement:

Palin rails against Obamacare in her usual eloquent, measured tones.

The 2+ minute long video is available to view on YouTube here:

I comprehensively “refudiated” Sarah Palin’s “death panel” claims on this blog a year ago, as did every other sentient person on the internet, so there is no need to cover this old territory. So where to start with this latest deliberately provocative outburst by the half-term governor from Alaska?

Perhaps with the fact that the GOP-led House of Representatives has now voted 40 times to repeal ObamaCare, each time in the full knowledge that the repeal would never pass the Democratic-held Senate, let alone be signed by President Obama.

Or maybe the fact that Obamacare (or the Patient Protection and Affordable Care Act, to use the correct title) is President Obama’s signature domestic legislative accomplishment, he campaigned on a platform of health reform in 2008 and won re-election by a significant popular and electoral college majority in 2012 after having brought it to fruition.

Nor has the “grassroots tsunami” against the bill, invoked by Senator Rand Paul, materialised in any meaningful way. Polls continue to show the American public divided in support of the word Obamacare itself (a testimony to Republican misinformation and scare tactics), but broadly supportive of the various measures contained within the bill.

And so apparently the only recourse left to Palin and her legion of fact-averse followers is to dust off the violent, revolutionary rhetoric as though Obama were King George reincarnate.

I make no apology for always assuming the worst about Sarah Palin’s motives, so my theory for this bizarre use of phrasing in her appeal for a popular revolt against Obamacare is that she deliberately used the word “bomb” in the knowledge that the fiftieth anniversary of the 16th Street Baptist Church bombing was fast approaching, hoping to get a rise out of offended liberals who would then accuse her of race-baiting or racial insensitivity, allowing her to play her patented Palin Persecution Card and receive even more unearned air time.

If you think that this is a harsh accusation to level against someone, recall that Palin has accused the president of the United States of “palling around with terrorists”, treason and a litany of other crimes and misdemeanors. Accusing Palin of being a sneaky, calculating, insensitive charlatan is pretty mild by comparison.

First we had this…

First we had the gun sights over Democratic-held congressional districts that Sarah Palin’s PAC was targeting in the 2010 midterms. Looking at this action in isolation, I can understand and forgive; showing literal targets over parts of the map that Republicans want to target politically does not seem unreasonable or violent to me, and I felt that the left-wing furore and attempts to link the imagery to the Gabrielle Giffords shooting in Arizona were craven and opportunistic.

But there is no comparable popular imagery relating to a bomb. We don’t talk about bombing a goal that we want to accomplish in the way that we might talk about targeting a goal or an aspiration. The word “bomb” has connotations only of violence and terrorism.

Sarah Palin, of course, does not wish for any literal bombs to be detonated in opposition to Obamacare, and would doubtless be horrified and appalled if one of her supporters were to read her words too literally and actually start blowing things up. But she is quite happy to use a charged, loaded word – a word associated only with war and terrorism – in relation to the US healthcare debate, to ensure that her fading political voice gains more prominence.

It doesn’t make Palin a terrorist supporter. But it does reveal her to be a shrewd, conniving, opportunistic and (still) dangerous political presence, willing to say and do almost anything to demonstrate her opposition to President Obama’s policies and legislative accomplishments.

Like this:

Normally, I try not to lend this person’s activities any of my time or attention, but Politico reports that Sarah Palin is resurrecting her scaremongering “death panel” message in anticipation of the upcoming US Supreme Court ruling on the new health care law’s constitutionality.

Says Politico:

Palin charged in a August 2009 Facebook post that the Democrats’ health care bill would empower a “death panel” of government bureaucrats who can decide who lives or dies. The 2009 claim earned Palin Politifact’s “Lie of the Year,” but she said today that the president’s health care law’s Independent Payment Advisory Board makes life-or-death decisions.

“It was a pretty long post, but a lot of people seem to have only read two words of it: ‘death panel,’” Palin wrote today. “Though I was called a liar for calling it like it is, many of these accusers finally saw that Obamacare did in fact create a panel of faceless bureaucrats who have the power to make life and death decisions about health care funding.”

No, Palin. People read the whole thing, their minds just stuck on those two words – “death panel” – because it was such an outrageous distortion of one of the best bits about the Affordable Care Act, or ObamaCare. Requiring health insurance providers to cover end-of-life care discussions between patients and their doctors was an excellent idea, one that would have encouraged thousands of Americans to decide whether or not they would want very aggressive and costly treatment during their final days, potentially saving them or their loved ones from unnecessary and prolonged pain and anguish when the time comes, not to mention saving vast sums of money and lowering insurance premiums for everyone.

Equating this with a room full of stern bureaucrats weighing the value of your life in their hands and deciding whether or not you are worthy of treatment was a case of shameful fantasy and hyperbole, and ultimately resulted in this provision being struck from the finished law – and you think that you are doing the American people a service?

Essentially, this seems to come down to a quibble about which invisible, mysterious forces are allowed to exercise life-or-death decisions over us (for after all, there is potentially unlimited demand for healthcare, and very limited resources to go around). Palin seems to prefer the invisible hand over the faceless bureaucrat, but if she could think in full colour rather than monochrome black/white, right/wrong for just a moment, she might realise that rationing of healthcare inevitably occurs in any system, and that the unchecked free market is little better a solution than the dark room of emotionless socialist bureaucrats created by her fevered imagination.

“The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society’, whether they are worthy of health care. Such a system is downright evil” – Sarah Palin, August 2009

“Barack Obama is the most dangerous president in modern American history. This administration has intellectually disarmed, it is morally disarmed, it is incapable of describing what threatens us” – Newt Gingrich, Republican Presidential Candidate, February 2012

“People have birth certificates. He doesn’t have a birth certificate. He may have one but there’s something on that, maybe religion, maybe it says he is a Muslim. I don’t know. Maybe he doesn’t want that. Or he may not have one. But I will tell you this. If he wasn’t born in this country, it’s one of the great scams of all time” – Donald Trump, Improbably Rich Idiot, March 2011

On the Federal Budget.

The US national debt stood at $10.6 trillion when President Obama took office, and in 2011 reached $14.6 trillion. Cue lots of self-righteous bluster from the American right that Obama is wrecking the national finances and, to use a much overwrought phrase “running up the national credit card” that the next generation will have to pay off.

You can agree or disagree with Obama’s economic stimulus, and TARP, and the auto bailouts – though as I remind my Republican friends, it is easy to criticise all of these measures and claim that they had no positive effect when none of us will ever have to live in an alternate reality where they had not taken place. What you cannot do, however, is pose as a staunch fiscal conservative and a concerned American worried about the financial stability of the United States if you have done any of the following:

Voted to approve the wars in Iraq and Afghanistan without seeking additional revenues to fund them.

Voted for Medicare Part D, the prescription drug programme for elderly Americans, again with no commensurate revenue increases (strange how “government-run healthcare” is an assault on individual liberty, with the huge exception of Medicare).

Voted for or supported the Bush tax cuts of 2001 and 2003 that were not met with equal cuts to government spending.

Obstructed the recent vote to raise the US debt ceiling, raising fears of a default and directly resulting in the downgrading of the government’s AAA credit rating.

On Religious Liberty.

I have amused myself watching several of the Republican presidential candidates twisting themselves in rhetorical knots trying to make the case that the founding fathers were only joking when they enshrined a “wall of separation between church and state” in the constitution (in Rick Santorum’s case, he went as far as to say that it made him physically sick to contemplate). Or rather, that it exists in much the same way as a cell membrane permits osmosis, allowing religion (or rather, certain favoured religions and denominations) to impose their beliefs beyond their congregations on the entire US population while making religious organisations themselves immune from any requirement to conform to state or federal laws.

If we take as one example the recent furore over the fact that the Affordable Care Act (ACA, ObamaCare) mandates that insurance companies provide birth control coverage, it is telling that many of the religious prelates – including many Catholic Bishops – have lived under similar requirements to provide employees with insurance that includes birth control in their home states for many years without raising a chorus of objection, until the same issue came up at a federal level. One cannot help but feel that religion and the concept of religious freedom are being used as a convenient cudgel with which to bash the Democrats in an election year, rather than being truly respected and protected by the GOP.

In terms of the Tea Party, there seems to be a genuine if uneven split between the minority true libertarians (of the Ron Paul mould) who believe in a separation of church and state and have the courage to say so, and the bulk of those others who are able to maintain in their minds the cognitive dissonance that must surely arise when you advocate for individual liberty in the economic realm on one hand, but insist that people abide by select teachings from your holy book (whichever it may be) on the other.

On Healthcare.

Being a conservative used to mean being a realist, dealing with the world as it is and hopefully proposing pragmatic, typically non-radical solutions. One of the persistent problems with the US healthcare system is the “free rider” problem. Hospitals are required to treat and care for any patient that arrives suffering from a grave, life-threatening injury or illness, regardless of whether or not that patient carries health insurance. Of course, this includes the more than 30% of Americans who lack such insurance. Even the most fervent tea-partier would (probably) pause before proposing that people be left to die on the street if they are in need of medical care but lacked insurance.

Unfortunately, this creates a rather significant free rider problem, with US taxpayers and health insurance policyholders essentially paying to cover the cost of these uninsured healthcare expenses. This contributes to the unsustainable rate of inflation in US healthcare costs, makes no sense and is just plain silly. Even the conservative Heritage Foundation used to think so too, and at one time proposed an individual mandate requiring all citizens to purchase at least basic health insurance (http://www.forbes.com/sites/aroy/2011/10/20/how-a-conservative-think-tank-invented-the-individual-mandate).

But now any such mandate is considered a grave assault on liberty. Okay, constitutional scholars can debate that point for a long time. But pragmatic conservatives should surely try to find a way around this issue, to solve the serious free rider problem which makes healthcare more expensive for everyone. Instead, the tea party rail against the “tyranny” of having to purchase healthcare, and yet say nothing about the free rider problem which hurts lower income people most of all in the form of higher insurance premiums and medical bills. Neither do they propose an alternative solution to address the fact that so many of their fellow citizens – some through choice but many through no fault of their own – live with the daily fear that accident or sudden illness could bring them to ruin. And no, promising to clamp down on medical malpractice lawsuits and muttering quietly about perhaps allowing insurers to sell policies across state lines, while both sensible ideas, do not solve a problem of this magnitude.

I could go on to talk about “death panels” – the GOP’s term for the basic idea that end-of-life care counselling should be offered (not mandated, just offered) as part of health insurance policies in order that more people are given the opportunity to make these key decisions while they are young and healthy, and potentially avert the suffering and huge proportion of total lifetime medical expense which is incurred during the end stages of terminal diseases, through the issuance of Do Not Resuscitate Orders etc. But there is no need, because anyone who reads the language in the Affordable Care Act (ACA) and somehow extrapolates in their mind that offering end of life counselling as part of an insurance plan could in any way equate to a “death panel” that decides whether the disabled or infirm should live or die is clearly smoking something quite mind-alteringly potent and will not be swayed by anything committed to print here.

I could also talk about the fact that the GOP’s constant use of the term “government-run healthcare”, or suggestions that government has taken over the healthcare industry (i.e. nationalisation) are ludicrous, alarmist and clearly and demonstrably false. But again, there is no need, because any thinking person should be able to see that while government may have now infringed on the way that consumers choose their health insurance provider (to some limited extent, in certain cases), this insurance and the healthcare itself is still provided by private-sector or non-profit organisations as much as it ever was. Those who scream “government takeover” or “socialism” would do well to go back to school and relearn the meaning of those terms – were it not for the fact that getting a college education is, of course, a form of snobbery these days.

But there is no need to talk about these things. At present there is no reasoning or engaging at all on the topic of health reform with the Tea Party-beholden GOP, who, in the words of David Frum, “followed the most radical voices in the party and the movement, and [were led] to abject and irreversible defeat”. (http://www.frumforum.com/waterloo). ObamaCare is here now, with all of its benefits and imperfections. The Republicans had an opportunity to engage with the Democrats and ensure that some more conservative principles were included in the law. Instead, they chose obstructionism and got none of what they wanted.

Why Now?

I am curious about this, and I would love for any thinking, Tea Party-supporting readers to comment and to help educate me. I do not believe that the recent groundswell of constitutional originalism and small government fervour is entirely the result of resentment that a black man currently occupies the Oval Office. I think it is a factor, but not the only one, or even the main one necessarily.

However, given the fact that the US federal government expanded in terms of raw expenditure, percentage of GDP, scope of activities and power over the individual for many years prior to the election of Barack Obama, I would like to understand – why the Tea Party, why now? Why the sudden need in 2009 for people to buy pocket editions of the US constitution, to dress up in 18th century clothes, to attend these rallies and rail against the subversion of America? Why deselect long-serving and relatively competent congressional representatives in favour of unknowledgeable and in some cases laughable primary challengers who vowed even before getting to Washington (or declaring on television that they are not a witch and being comprehensively beaten, in one depressing case) that they would never seek to strike a bipartisan deal?

If you are a fiscal conservative, that’s great, campaign for greater fiscal responsibility. If you believe in small, limited government – marvellous, advocate strongly for it (I assume that your enthusiastic support of individual liberty applies to peoples’ bedroom and nuptial activities too though, right?) If you believe that some of the key edifices of the American social safety net and federal government are technically unconstitutional, then you can probably make that argument quite convincingly. But before you do any of those things, and if your name is not Ron Paul, please explain where you stood, and who and what you voted for in the months and years prior to Inauguration Day, 2009.